Dealing With Adverse Events: A Meta-analysis on Second Victims’ Coping Strategies

Source avec lien : Journal of Patient Safety, 16(2), Jun-20. 10.1097/PTS.0000000000000661

Malgré l’intérêt croissant pour le phénomène de la seconde victime et une plus grande sensibilisation à ses conséquences, il n’y a pas eu de méta-analyse quantifiant l’impact négatif des événements indésirables sur les prestataires impliqués dans les événements indésirables. Cette étude a systématiquement passé en revue les types et la prévalence des symptômes psychologiques et psychosomatiques chez les secondes victimes.

Objectives  Despite the critical need to understand the diverse responses by second victims to adverse events, there has not been a meta-analysis examining coping by second victims. We aimed to analyze the coping strategies applied by second victims in the aftermath of adverse events. Methods  We performed a systematic search of nine electronic databases up to October 2018 and screened additional sources, such as gray databases. Two independent reviewers conducted the search, selection process, quality appraisal, data extraction, and synthesis. In case of dissent, a third reviewer was involved to reach consensus. Quantitative studies of the frequency with which coping strategies were applied by second victims were eligible for inclusion. We calculated the overall frequency of coping strategies and I2 statistic using random effects modeling. Results  Of 10,705 records retrieved, 111 full-text articles were assessed for eligibility and 14 studies eventually included. The five most frequent coping strategies were Changing work attitude (89%, 95% confidence interval [CI] = 80–94), Following policies and guidelines more accurately and closely (89%, 95% CI = 54–98), Paying more attention to detail (89%, 95% CI = 78–94) (task oriented), Problem-solving/concrete action plan (77%, 95% CI = 59–89) (task oriented), and Criticizing or lecturing oneself (74%, 95% CI = 47–90) (emotion oriented). Conclusions  Second victims frequently used task- and emotion-oriented coping strategies and, to a lesser degree, avoidance-oriented strategies. To better support second victims and ensure patient safety, coping strategies should be evaluated considering the positive and negative effects on the clinician’s personal and professional well-being, relationships with patients, and the quality and safety of healthcare.

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